Showing papers in "American Journal of Drug and Alcohol Abuse in 1982"
TL;DR: Benzodiazepine therapy should be stopped as early as possible, with tapering after moderate dose and/or prolonged use therapy, and reactions may also occur with the short-acting agents.
Abstract: The capacity of the benzodiazepine drugs to produce dependence and addiction has been associated with what has recently been recognized as a benzodiazepine withdrawal syndrome. Abrupt discontinuati...
80 citations
TL;DR: Multiple data checks showed that drug abusers' self-reports of recent alcohol and drug use and of arrests and hospitalizations over a 2-year period are sufficiently valid for use in treatment outcome research.
Abstract: Multiple data sources were used to evaluate the validity of 31 drug abusers' self-reports of recent drug use as well as related behaviors occurring 1 year before and 1 year immediately after admission to a drug-free therapeutic community. Interviews were conducted by individuals not associated with the program. At the initial interview subjects provided a breath test for alcohol and a urine sample to test for other recent drug use. Subjects also signed releases of information so that official records could be checked both before and after admission to treatment to document any hospitalizations, arrests, drug treatment facility stays, and driver's license suspensions or revocations. These multiple data checks showed that drug abusers' self-reports of recent alcohol and drug use and of arrests and hospitalizations over a 2-year period are sufficiently valid for use in treatment outcome research. When differences occurred, it was usually due to subjects reporting more events than appeared on the records.
58 citations
TL;DR: It is suggested that supervised methadone maintenance is compatible with an uneventful pregnancy and delivery and Neonatal complications, with the exception of withdrawal, do not appear to differ from that seen among infants born to nondrug dependent women.
Abstract: The records of 239 infants born to 228 women dependent on narcotic drugs were reviewed to determine if type of drug abused and adequacy of prenatal care would affect pregnancy and fetal outcome. Seventy-nine (33%) pregnancies occurred in women on supervised methadone maintenance, 78 (32%) in women on unsupervised methadone maintenance, 49 (21%) in women on street heroin, and 33 (14%) in women who were multiple drug users. Although the presence of withdrawal symptoms did not differ with respect to type of drug abused, the outcome was significantly better in those infants born to women on supervised methadone maintenance as compared to all other groups (p < 0.001). There was no demonstrable relationship between the number of prenatal visits to the clinic and fetal outcome. A relationship could not be demonstrated between the maintenance dose during pregnancy and the presence of withdrawal symptoms in the infants born to women on supervised methadone maintenance. The findings of the study suggest that superv...
50 citations
TL;DR: The abuse of drugs by alcoholics, the abuse of alcohol by drug abusers, the prevalence of alcohol abuse in polydrug clients, and the role of alcohol as a steppingstone are examined quantitatively over the past decade.
Abstract: The abuse of drugs by alcoholics, the abuse of alcohol by drug abusers, the prevalence of alcohol abuse in polydrug clients, and the role of alcohol as a steppingstone are examined quantitatively over the past decade. The increase of drug abuse by alcoholics and the increase of alcohol abuse and alcoholism by polydrug abusers is documented. This is accounted for mainly by an increase of drug abuse in younger and/or female alcoholics. The abuse of alcohol by heroin addicts has also increased, particularly when heroin purity diminishes and when these clients cycle through methadone maintenance. However, much of the alcoholism in these patients began prior to the onset of heroin use and dependence. Methods of treatment modifications necessary to deal with problems presented by these combinations are discussed.
47 citations
TL;DR: It was found that program policies involving the use of flexible dosages were associated with greater retention in treatment, and service delivery elements to dosage policy within methadone maintenance programs were explored.
Abstract: Study was made of the relationship between methadone dosage policy and retention in drug abuse treatment. Responses were obtained from administrators of 113 methadone maintenance programs represent...
46 citations
TL;DR: Conventional social-science wisdom about the family background of substance abusers breaks down into three hypotheses: the broke-home hypothesis, the overprotective-mother hypothesis, and the increased-control hypothesis, which are logical extensions of Freudian theory, early social- learning theory, and revised social-learning theory respectively.
Abstract: Conventional social-science wisdom about the family background of substance abusers breaks down into three hypotheses. The broken home causes substance abuse; overprotective mothers with or without neglectful fathers cause substance abuse; substance abuse is reinforced by the changes it brings about in family interaction. The broken-home hypothesis attributes substance abuse to sheer absence of a parent, usually the father. The overprotective-mother hypothesis emphasizes the effect of indulgent, dominant mother behavior sometimes combined with ineffectual father behavior. The increased-control hypothesis emphasizes the effects of substance abuser, parents, and siblings on one another. Because investigations of these hypotheses are necessarily correlational, existing research on the family backgrounds of substance abusers suffers from methodological flaws characteristic of weak correlational designs. These hypotheses are logical extensions of Freudian theory, early social-learning theory, and revised socia...
35 citations
TL;DR: This population of elderly alcoholic patients treated as successfully as younger patients, and their abstinence percentage combined for the two treatment years was 65.4% continuous sobriety over a 12-month follow-up period.
Abstract: The purpose of the present research was to assess the treatment effectiveness of a multi-modality alcoholism treatment program with older alcoholic patients. Treatment success was defined as 1 year of sobriety following inpatient treatment in a multicomponent program oriented around aversion conditioning to alcohol. A total of 87 patients, 65 years or older, were admitted, and a total of 78 patients were treated in the Raleigh Hills Hospital-Portland over a 2-year period. Descriptive psychological test data, demographic characteristics, and symptom history data were obtained for these patients and related to treatment outcome. This population of elderly alcoholic patients treated as successfully as younger patients. Their abstinence percentage combined for the two treatment years was 65.4% continuous sobriety over a 12-month follow-up period.
34 citations
TL;DR: Patients with more stable life histories in terms of employment and family background were less often readmitted and perception of the treatment ward as more autonomous was related to longer community tenure.
Abstract: The aim of this study was to determine demographic and psychological predictors of rehospitalization in a group of 238 alcoholic patients followed 6 months after hospital discharge. The relationship of the person's perception of the treatment environment and whether treatment was completed or not was also studied in regard to readmission. At the time of admission to an inpatient Substance Abuse Treatment Unit, patients gave demographic and medical, social, and vocational histories. They also completed a battery of psychological tests which measured symptoms, mood, and motivation. One week after admission they rated their perception of the treatment unit in regards to 12 dimensions of ward atmosphere. Of the 200 patients available for follow-up, 125 completed the 30 to 50 d treatment and 75 did not. Thirty percent of the patients were readmitted within 6 months. Patients with more stable life histories in terms of employment and family back-groud were less often readmitted. Being depressed, angry, inert, a...
30 citations
TL;DR: This exploratory study observed that Puerto Rican addicts seemed to present with values that differentiate them from their Black and White counterparts and followed up initial observations by defining and rating six cultural themes as displayed in response to a sentence completion task.
Abstract: In this exploratory study, the authors first observed that Puerto Rican addicts seemed to present with values that differentiate them from their Black and White counterparts and followed up initial observations by defining and rating six cultural themes as displayed in response to a sentence completion task. Statements referring to four of these themes (the importance of the mother, machismo, the obligation to the family, and the need for respect) were made more often by a sample of Puerto Rican addicts when compared with Black and White control subjects. The clinical importance of recognizing the unique values of addicts from differing cultural groups is discussed.
29 citations
TL;DR: A point of diminishing returns in single vehicle fatalities was found when the outlet density was less than one outlet per million of the drinking age population, which appears to reflect the additional driving required to make purchases in areas where outlets are sparse.
Abstract: Two elements of alcohol availability, the frequency of packaged-liquor outlets and state monopoly of distribution, were assessed in terms of their impact on fatal single motor vehicle accidents. A cross-sectional analysis of the United States employed a multiple regression analysis which statistically controlled for average mileage driven, the degree of urbanization, and the proportion of male drivers. State monopoly of distribution was not associated with single vehicle fatalities while a significant and positive association was obtained for the frequency of outlets. A point of diminishing returns in single vehicle fatalities was found when the outlet density was less than one outlet per million of the drinking age population. This reversal of the relationship appears to reflect the additional driving required to make purchases in areas where outlets are sparse. The social policy implications of the findings are discussed.
28 citations
TL;DR: The general mental health, including cognitive function, of sober chronic alcoholics is clearly impaired when compared to sober nonalcoholic individuals.
Abstract: Sober chronic alcoholic males, sober nonalcoholic males, and intoxicated nonalcoholic males were assessed along several psychological dimensions by means of the content analysis of speech Average cognitive impairment scores were significantly greater among intoxicated nonalcoholics than sober chronic alcoholics and significantly greater in sober chronic alcoholics than in sober nonalcoholics Sober chronic alcoholics, also, had a significantly higher score than sober nonalcoholics on depression, social alienation-personal disorganization (schizoid traits), separation, guilt, and diffuse anxiety, and hostility inward The general mental health, including cognitive function, of sober chronic alcoholics is clearly impaired when compared to sober nonalcoholic individuals
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TL;DR: The different ways in which grief effected patterns of alcohol consumption were demonstrated, including the responses to marital loss by separation or divorce and the resolution of pathological grief was not inevitably associated with containment of alcohol intake after treatment.
Abstract: A survey of clinical case histories revealed the presence of grief in 12 out of 50 consecutive admissions in an alcohol treatment center. Eight additional cases were added to this series. The bereavements had occurred in 14 established alcoholics, and initiated alcoholism in six patients, five of whom described close relatives with excess alcohol intake. This study demonstrated the different ways in which grief effected patterns of alcohol consumption. The chronic intoxicated state could also influence the expression of grief and the process of mourning. Resolution of mourning could occur concurrent with increased intake. Pseudo-grief in the heightened emotional state of the withdrawal phase could be transient. Variants of pathological grief were present in half (N = 10) of whom five came from the initial survey group. Its form of expression could be related to premorbid personality. Completion of the withdrawal phase was found essential for meaningful diagnostic assessment. The resolution of pathological...
TL;DR: A multivariate analysis of data from high school seniors reveals that only respondent's personal standards and number of close friends who drink exert a major influence on respondents' beer use, while the standards of other students explains an additional small part of the variance.
Abstract: Although the past literature has hypothesized that alcohol consumption on the part of adolescents is influenced by the use patterns and standards of peers, parents, and community, a multivariate analysis of data from high school seniors reveals that only respondent's personal standards and number of close friends who drink exert a major influence on respondents' beer use, while the standards of other students explains an additional small part of the variance. Similarly, only friends' beer use and standards, in addition to the frequency of respondents' beer use, had significant correlations to drinking problems. Use patterns and standards of parents, as well as standards of close friends and of the adult community, had no appreciable relationship to adolescent alcohol use or problems. The greater importance of self-standards among late adolescents is consonant with theories of development of identity and autonomy.
TL;DR: Compared samples of delinquent and nondelinquent adolescent male drinkers matched on age and race duplicated those developed for a national probability survey of teenaged drinking practices conducted in the United States during 1974-1975, and delinquent problem drinkers drank more, drank more frequently, reported more negative consequences from drinking in more areas, and perceived themselves as having a drinking problem more often than nondel Inquiry problem drinkers.
Abstract: Clinical evidence suggests that problem drinking among adolescent delinquents is more severe than among nondelinquents and is accompanied by greater social pathology. This investigation explored this question empirically by comparing samples of delinquent (n = 49) and nondelinquent (n = 100) adolescent male drinkers matched on age and race and controlling for community size and region of the country. Criteria for problem drinking and other measures duplicated those developed for a national probability survey of teenaged drinking practices conducted in the United States during 1974–1975. Results replicated the often-reported higher incidence of problem drinkers among delinquents than non-delinquents. More to the point, delinquent problem drinkers showed severer involvement with alcohol and drugs and more signs of social pathology than non-delinquent problem drinkers. Delinquent problem drinkers drank more, drank more frequently, reported more negative consequences from drinking in more areas, and perceived...
TL;DR: The findings indicate that AA among narcotic addicts and those on MMTP consume large quantities of EtOH but that consumption decreases with time onMMTP, and suggests that entry and participation in MMTP has a broader effect than just on the use of narcotic drugs.
Abstract: Alcohol use among methadone maintenance treatment program (MMTP) patients is substantial and a frequent impression is that addicts accelerate their consumption once in MMTP. This study reports an attempt to more clearly define alcohol consumption in opioid dependence as well as changes associated with methadone maintenance therapy. Two-day alcohol consumption (2-day EtOH) data were collected initially and quarterly on participants in a randomized controlled trial of intervention for alcoholism. Blood alcohol levels (BAL) were also determined. 17% of the participants were classified as active alcoholics (AA) and 8% as inactive alcoholics (IA). Two-day EtOH and BAL were significantly higher for AA than AI and nonalcoholics (NA, and AI higher than NA. Two-day EtOH decreased significantly over time for AA, AI, and NA. These findings indicate that AA among narcotic addicts and those on MMTP consume large quantities of EtOH but that consumption decreases with time on MMTP. The results, in confirmation of the wo...
TL;DR: The QIAD proved to be both reliable and valid in comparison to other currently used severity (DBI) and diagnostic (MAST, DRC, NCA) scales.
Abstract: The Quantitative Inventory of Alcohol Disorders (QIAD) was developed to meet the need in the field of alcoholism treatment for an accurate, easily administered diagnostic tool which can measure the severity of alcoholism. This inventory is designed to be administered both on initial contact and as a follow-up after a given period of treatment. In addition to clearly differentiating alcoholic from nonalcoholic populations, the QIAD also proved to be both reliable and valid in comparison to other currently used severity (DBI) and diagnostic (MAST, DRC, NCA) scales.
TL;DR: Empirical evidence supports long-term detoxification that recognizes other factors as also having a therapeutic effect and shows the 3-week limit is shown to interfere with achieving successful detoxification rates, although it continues to guide federal detoxification policy.
Abstract: The current federal narcotic detoxification policy, limiting such treatment to 21 d, is analyzed with respect to its impact on the success rate for complete withdrawal. Data are drawn from an historical review of American Medical Association statements on narcotic addiction and a review of empirical data on short- and long-term detoxification. The 3-week limit is shown to interfere with achieving successful detoxification rates, although it continues to guide federal detoxification policy. Empirical evidence supports long-term detoxification that recognizes other factors as also having a therapeutic effect. It is time to revise the current federal policy to more accurately reflect the progress made in long-term care.
TL;DR: The table, which contains the proprietary drug name, manufacturer, type and concentration of alcohol, route of administration, and prescription:nonprescription status, is intended to aid clinicians in counseling patients receiving alcohol-deterrent drugs or patients in whom alcohol should be avoided.
Abstract: Ethanol and isopropranol are found as an active ingredient in oral, parenteral, and topical (including inhalational) prescription and nonprescription drug products. Although it is primarily used be...
TL;DR: Recidivism rates and recidivism proportions for return to a state of daily opioid use following discharge from drug abuse treatment were studied for a sample of Black and White male daily opioid users.
Abstract: Recidivism rates and recidivism proportions for return to a state of daily opioid use following discharge from drug abuse treatment were studied for a sample of Black and White male daily opioid users. The rates and proportions were analyzed by treatment type and time in treatment. Significantly higher recidivism proportions were found for shorter tenure clients.
TL;DR: The blood alcohol levels were determined in 100 Los Angeles County homicide victims who died in August 1980 and it appears that alcohol use is one factor that increases the chances of a person becoming a homicide victim.
Abstract: The blood alcohol levels were determined in 100 Los Angeles County homicide victims who died in August 1980. A total of 61% had levels of 0.01% or more. Since this percentage is substantially higher than would be expected for a cross section of the population, it appears that alcohol use is one factor that increases the chances of a person becoming a homicide victim.
TL;DR: It was found that 60% of the total sample reported no opioid drug use and 78% reported no daily use during the year immediately before the follow-up interview, while long-term status was slightly more favorable for persons treated in DARP, MM, TC, and DF programs, compared to DT and IO clients.
Abstract: A sample of 2,099 Black and White male daily opioid drug users admitted to drug abuse treatment programs located across the United States were followed up 5 to 6 years after admission. Follow-up interviews focused on posttreatment behavioral functioning, including drug and alcohol use, treatment reentry, criminality, and employment. The sample included Black and White males in the nationally oriented Drug Abuse Reporting Program (DARP) who were admitted to methadone maintenance (MM), therapeutic community (TC), outpatient drug-free (DF), and outpatient detoxification (DT) programs; in addition, intake-only (IO) who never returned to receive treatment in the DARP were included as a comparison group. This study examined the status of these former addicts during the year immediately before the follow-up interview. It was found that 60% of the total sample reported no opioid drug use and 78% reported no daily use. Furthermore, over one-third had no illicit drug use at all during the year, as well as no arrest...
TL;DR: The medical and sociological aspects of T's and Blues abuse in New Orleans were studied to determine the effect of abuse on the medical and psychological status of the individuals involved and the sociological effects on the community in general.
Abstract: The medical and sociological aspects of T's and Blues abuse in New Orleans were studied to determine the effect of abuse on the medical and psychological status of the individuals involved and the sociological effects on the community in general. Sociologically, the most pertinent findings were an increase in the number of (1) deaths related to the use of T's and Blues, (2) arrests and revocation of parole for possession and/or sale of Talwin, and (3) a decrease in the number of arrests for the possession and sale of heroin. In the medical and psychiatric context of this study, three distinct groups of addicts were found of which the T's and Blues users were the largest. Psychiatrically, the most pertinent observation was the high (30–35%) incidence of paranoid, violence prone life-styles seen among T's and Blues users. This finding certainly is in accord with the increased homicide rate and T's and Blues related deaths noted in other aspects of this study.
TL;DR: Most officers felt that peer pressure is the main reason why people start to use marijuana and that youthful users and their parents are not well informed about its effects, suggesting important demographic factors which determine acceptance of current drug law changes.
Abstract: The attitudes of a major metropolitan police force were surveyed with regard to their beliefs about marijuana; especially, their beliefs about the effects of marijuana, the enforcement of laws for possession, and the causes for marijuana use. The results indicated that most officers felt marijuana was harmful (physically as well as psychologically) but not necessarily more so than alcohol; 31% believed that possession of small amounts (<1 oz) should be decriminalized, and 85% did not believe that current laws for possession of small amounts were being actively enforced; most officers felt that peer pressure is the main reason why people start to use it and that youthful users and their parents are not well informed about its effects. The officers' rank, educational level, and whether or not they had children were also significantly related to marijuana beliefs, suggesting important demographic factors which determine acceptance of current drug law changes.
TL;DR: Using Haley's concept of complementary and symmetrical relationships, this work intensively studied the role relationships of 28 male heroin addicts and their spouses, finding that couples had an alternating sequence of two complementary role relationships.
Abstract: Using Haley's concept of complementary and symmetrical relationships, we intensively studied the role relationships of 28 male heroin addicts and their spouses. These couples had no symmetrical role relationships, but had an alternating sequence of two complementary role relationships. These complementary roles sequentially alternated from a compliant child with a nurturing mother, when the wife would deny her husband's drug abuse; to a rebellious son with a policing mother, when a financial or legal crisis would force her to confront his addiction. After this crisis, the couple entered treatment in the unstable complementary roles of contrite child and policing mother. During treatment, the wife was educated and supported to confront early signs of drug abuse, thus avoiding its denial, and the couple was encouraged to develop symmetrical roles by beginning to share minor responsibilities.
TL;DR: In general, it appears that the growth of the scientific literature included under many of these headings has been more rapid than the overallrowth of the literature.
Abstract: Publications dealing with psychotropic drug use and dependence were analyzed for the years 1960–1980 using the numbers of articles cited in each yearly edition of Cumulated Index Medicus. The following headings were reviewed: drug abuse, drug dependence, alcoholism, smoking, heroin addiction, cannabis, cannabinoids, cocaine, phencyclidine, lysergic acid diethylamide, diazepam, and meprobamate. The number of citations for a given year was used to calculate the percentage of the literature for that year which fell under each of those headings. In general, it appears that the growth of the scientific literature included under many of these headings has been more rapid than the overall growth of the literature.
TL;DR: It is suggested that although elevations in LFTs are frequently present in narcotic addicts and are significantly greater among addicts who are also alcoholic, most elevations are not specifically due to alcohol and conventional LFTS are therefore of limited value in assessing alcoholism among Narcotic addicts.
Abstract: Liver Function Test (LFT) abnormalities are frequently observed in narcotic addicts. However, the role of alcohol in producing such changes remains unclear. In order to evaluate the effects of alcohol in producing LFT elevations as well as the use of routine LFTs to serve as biochemical markers for alcoholism in narcotic addicts, 612 addicts participating in a randomized control trial of intervention in alcoholism were studied. Baseline parameters including LFTs and history of alcohol use were obtained on entry into the study and subsequently periodically during follow-up which varied from 6 months to 2 years (mean 13.5 months). On entry to the study, 104 of 612 (17%) of addicts were classified as alcoholics. Mean values of LFTs (SGOT, SGPT, Alkaline phosphatase, GGTP) in the alcoholic cohort were significantly increased compared to those among nonalcoholics (p < 0.01 to <0.001 for individual tests). Mean values of LFTs did not significantly change during methadone maintenance in either group. Although a ...
TL;DR: Results suggested that alcoholic subjects tended to make greater internal attributions for their own drinking than did nonalcoholic subjects, and actor-observer differences in causal attributions depended on both the subjects' and targets' drinking histories.
Abstract: Alcoholic individuals often are assumed to deny personal responsibility for their alcoholism and to attribute causation to external situational factors. To investigate this assumption, in a 2 x 2 factorial design 20 alcoholics and 20 nonalcoholics made causal attributions for a recent personal drinking episode and for the audiotaped episode of a target individual who was described as either an alcoholic or a nonalcoholic. Results suggested that alcoholic subjects tended to make greater internal attributions for their own drinking than did nonalcoholic subjects. Subjects' attributions for the target individual depended on both the subjects' and targets' drinking histories. The results are discussed in terms of their relevance to models of alcoholism and to actor-observer differences in causal attributions.
TL;DR: Data are presented suggesting that drug abuse may be a problem at any point in the life-span and that the family is a natural laboratory for research dealing with this problem.
Abstract: The literature linking family-related drug abuse research and a life-span perspective is reviewed. Data are presented suggesting that drug abuse may be a problem at any point in the life-span and that the family is a natural laboratory for research dealing with this problem. Three subsets of the family/drug abuse literature relevant to a life-span perspective–Systems, Intergenerational, and Life-Cycle Studies-are identified and major studies within each briefly reviewed. Finally, in order to make a first step toward the integration of a life-span orientation with more traditional drug abuse research approaches, an extensive list of content-related and methodological research questions is suggested.
TL;DR: The similarity between typological systems based on the MMPI and CPI was investigated in a sample of male heroin users, and the possibility of predicting the configural patterns of one inventory from those of the other was explored.
Abstract: The similarity between typological systems based on the MMPI and CPI was investigated in a sample of male heroin users. The typologies had faiily high classification rates (85 and 75%, respectively) and evidenced relationships that seem consistent with psychological theory. Methods of using the two inventories and the respective typological systems in tandem were suggested, and the possibility of predicting the configural patterns of one inventory from those of the other was explored.
TL;DR: Client similarity was found to influence treatment outcome and peer relationships and the influence of similarity among clients should be considered in the formulation of treatment plans for individual clients.
Abstract: Client peer groups in drug abuse treatment programs can be expected to impact on the treatment of drug abusers. This ex post facto study explored whether similarity in demographic characteristics and drug use history within client peer groups influences treatment outcome. Subjects were 455 clients in outpatient drug-free treatment. Four aspects of similarity were assessed-age, drug use history, race/ethnicity, and sex. Follow-up data on levels of criminality, nonopiate drug use, and opiate drug use during the first year posttreatment were analyzed using multiple regression analysis. Client similarity was found to influence treatment outcome. While the findings do not warrant substantial changes in the delivery of drug abuse treatment, they suggest that peer relationships and the influence of similarity among clients should be considered in the formulation of treatment plans for individual clients.